The CEO Series: Rob Liebreich, Goodwin Living
By Jim Nelson | July 23, 2024
As staffing challenges continue to face senior living companies across the nation, Northern Virginia’s (aka NOVA) Goodwin Living has entered into an innovative partnership to help increase its opportunities for filling nursing positions.
Paraphrasing Goodwin Living’s CEO Rob Liebreich in a LinkedIn post, if you want to solve a problem, bring people together. “In the case of our nursing shortage we face in the Northern Virginia area,” Liebreich posted, “bringing together Northern Virginia Community College, Vinson Hall Retirement Community — Navy Marine Coast Guard Residence Foundation, Virginia Hospital Center — Arlington (VHC), and Woodbine Rehabilitation & Healthcare Center helped us create new nursing opportunities for 50 students.”
We checked in with Liebreich to get more details.
SENIOR LIVING NEWS: The data suggest that there are a million or more nurse openings across the country; what is Goodwin Living dealing with in that regard?
ROB LIEBREICH: We have 1,300 team members right now supporting our overall operations; of that, about a third are clinical-focused, from a certified nursing assistant, licensed practical nurse, or registered nurse perspective, and we’re recruiting about 25 percent to 30 percent of that population every year, just based on natural turnover. When it comes to service lines, like hospice service lines for example, our ability to grow is proportionately related to our ability to find and retain great RN case managers for hospice. We could serve a lot more people if we had these additional RN case managers. You have to find people that are really good operators on their own, without a whole lot of oversight, with very complex situations, because you’re talking end of life. So, we deal with about 100 people that we’re recruiting every year on the clinical side. And we now handle our own therapy services — that was something we outsourced for many, many years — which has been really important for our bottom line and our continuity of care. They lost a huge portion of physical therapists during COVID — 10 percent of the entire physical therapy field just decided, “I’m out, I’m not going to do this anymore.” Now finding a physical therapist is really tough. So that’s part of why, in addition to the work we’re doing on the school side with NOVA, we’ve also recently added a whole program related to tuition pay down, or tuition repayment. We’ve come at it with, “We’ll support you into school and pay $5,250 per year towards your schooling, but now we also understand so dramatically that some of our therapists, in particular, and clinical teams, RNs for example, they’re incurring a lot of expense to go to and through school, and they’ve already incurred it by the time they get to us so now we’re saying, “Okay, great, you want to stay with us? We’ll pay down $5,250 a year.”
SLN: And what about openings throughout the rest of your staff?
RL: We had been running about 30 percent turnover in the three years prior to last year, and last year we came in around 27 percent. That’s all inclusive of PRN staff, as-needed staff. When I’ve looked at the ratios without them, it’s lower, but I prefer to stay focused on the holistic number. So, 27 percent means we’re hiring 300 people, 400 people a year, somewhere in that range in total. About 100 of those positions are clinical-based and the rest are everything else: our environmental services, our culinary teams, our servers. And I think we’re getting better on those fronts. One, because we continue to focus on paying a competitive wage; we’re at $21 an hour pay structure for CNAs, baseline, which is good in our market area. We’re at $18.75 for anyone else as a baseline pay structure — that’s coming from $11.75 in 2019, so that’s 60 percent growth of pay structure at the same time that we’ve been attentive to benefit improvement.
We’ve been really trying to listen to our team members, and I think a key part of keeping people engaged with us has been, “Are we giving them a chance to voice their opinion? Are we hearing their opinion and executing on some actions that make their world better?” There’s still some positions here and there that are a struggle, but we’ve been working really hard to build up our systems of recruiting, and I think that’s helped us. We’re actually doing a lot with internships, bringing in high school students and college students at an earlier stage to get a feel for us, and that’s allowed us to hire a number of those folks and hopefully keep them for a longer period of time.
Overall, I’d say we’re in a strong position. We were identified as the top place to work this year by Washington Post in our region, so having all those parts come together has been helpful.
SLN: I read a story on one of your local news sites, WUSA9.com, that talked about your partnership with Northern Virginia Community College to address local nursing shortage. What can you tell me about that?
RL: That specific story came through a board member of ours who was the provost at the Medical Campus for Northern Virginia Community Colleges. And a few years ago now she said, “We’ve got COVID going on, but we also have this huge interest in nursing, and we’re not able to meet the demand that we’re seeing from all these students.” She said, “Eight hundred applicants, 600 are valid, only 80 slots.” And we said, “What’s your barrier to creating more slots?” “Well, we have the physical space; we have the interest from the students; our barrier is professors can’t get compensated enough to make it worth their while to come and teach. So, if you all could find a way to supplement the pay to pay what the market is asking, we think we can hire professors.”
SLN: Is hiring professors the full extent of the fund that you’ve created, or are there other things that it will take care of?
RL: It takes a while for all these classes to get established and curriculum to be set up. Even when you have curriculum there’s a lot of blessings that you have to get through the state. And when we stepped forward, we said, “We probably need $240,000 a year to make this work for the first two years, and if we can get it going for the first two years, then we can have it self-sustain; the state will supply support, there’ll be other ways to have support, so we don’t need it ongoing but we do need start-up capital.” We said, “We can’t provide all of that, but we will provide some of it; let’s go out to the market and see who else” — because we all are in the same situation; we all need more hands, talent, and clinical talent in particular. So, we said, “Let’s reach out to other not-for-profits, let’s reach out to for-profits, let’s talk to everybody.” We convened a group of operators in our market area — I think I had six that I went out to — and at the end of the day, we got one to commit in addition to ourselves, another not-for-profit. And when we had the second, the NOVA Foundation — the college — was able to go out and find a third, our first for-profit entity. And then they were able to get one of the standalone hospitals to also commit resources, so now we had our magic four each committing $60,000 a year towards the program and we’re able to compensate for the professor who’s going to be teaching the courses. And now we’ve got a cohort that can support 50 new licensed practical nurses in our market area, where that program didn’t exist before. And the program is stackable so the skills that they’re learning are going to be applicable right away. So even if they don’t finish the program — it’s a 13-month program — they’re still able to grow in their skill set and provide more capacity in whatever job that they are doing.
And the best news, I would say, is they’re going to be able to create weekend and evening nursing classes for the first time in our market area. In other market areas that’s shown to be really positive for being able to attract the attention of potential candidates.
SLN: So, you’ve got the potential for 50 new students and four of you have contributed to the fund; was there any discussion about how it can be equitably translated to actual staff for each of you?
RL: Yeah, I think the first acceptance is that we’re doing this for the betterment of all, so maybe we will benefit individually as organizations but ultimately, we know that 85 percent of students from Northern Virginia Community College stay in our market area so someone’s going to benefit, which is good, and ultimately society will benefit and that’s, at the end of the day, in line with our mission and our philosophy. And from a practical standpoint, we have opportunities to interview these candidates earlier in the process; we have opportunities to be practicum sites, so that we’re embedded in their training process and so we have a number of unique opportunities to reach in and convince these candidates — just like our other three providers of resources; all of us have the chance to meet, tell our story, convince folks that we’re a good provider, that they should come our way. No guarantees and I think some providers would want to guarantee, “If I’m providing you dollars, I want a guarantee of return on investment for that.” I would say this is a step to say, “We believe holistically that we will all benefit in our market area, and we’re willing to put it forward.” The first cohort just started with a smaller group of students, just to get going, but about 30 percent of those students actually are Goodwin Living team members already. So, we’re already seeing the value because these folks didn’t have an access point for that type of education before. Now they do, now I have three people that are being trained up as licensed practical nurses, that are going to be able to serve our organization in a really positive way.
SLN: I love it. You’ve started something that is going to put processes in place, but it’s going to be a while before there’s any potential for a payoff because the college has to hire a professor and do whatever they have to do to get a classroom ready to go, then you have to wait for the students to learn what they need to learn to be ready for you. In the meantime, how do you continue to deal with the staffing, and specifically nursing shortages, in the interim until you see some payoff for this fund?
RL: That’s a good question, for all of us. Our answer to that is it’s multifaceted. We don’t slow down on all the other parts that we’re working on. So, for us that means being an intentional organization of welcome so that people coming from other countries want to be a part of our organization — that plays right into our Citizenship Program — and it convinces people in our market area that, “Hey, we should join this organization; they care about us holistically.” So that’s something that we’re focused on. We are skilling up within our own organization, so if you’re a brand-new nurse coming through, and you graduate, typically what we hear from nurses is they want to go to the hospital because they get such great exposure to so many opportunities to practice their skills. Well, our organization is big enough now, and we have such a diversity of opportunities that we’ve created our own program for new nurses. So, if you’re a new nurse, we can help you skill up and gain access to certified home health or do something in assisted living or do something in skilled, right? We have the variety pack now that we can provide to nurses, for example. So that’s something new for us, we’re more intentional about welcoming in newer nurses with the confidence that we can skill them up, not waiting for them to go through a school program, for example. Those are some of the innovative programs.
A lot of the work we’re doing is coming through generous donations through our [Goodwin Living] Foundation that allows us to support these programs. The NOVA work, or the NVCC work, we’re doing is Foundation-supported; new nurse pathways that I just referenced is Foundation-supported for us as well.
We’re trying to hold on to our team members longer. A large portion of our team members are more mature and have been in the market for a longer period of time and we want them to know that we really care about them, we want them to stay with us. We really see them as valuable members of our team and do not want to have them exit too soon. So that’s part of the equation: How do we retain folks longer as well?
